The Importance of a Proper Against-Medical-Advice (AMA) Discharge: How Signing Out AMA May Create Significant Liability Protection for Providers

• Published in: The Journal of emergency medicine Vol. 43; no. 3; pp. 516 - 520
• Main Authors: Levy, Frederick, MD, JD, Mareiniss, Darren P., MD, JD, Iacovelli, Corianne, JD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2012
• Subjects: against medical advice; AMA; assumption of risk; capacity; disclosure; Disclosure - legislation & jurisprudence; Documentation; duty; Emergency; Emergency Service, Hospital - legislation & jurisprudence; Humans; liability; Liability, Legal; malpractice; Malpractice - legislation & jurisprudence; Mental Competency - legislation & jurisprudence; negligence; Patient Discharge - legislation & jurisprudence; protections; Risk Management; Treatment Refusal - legislation & jurisprudence; United States; United States; disclosure; assumption of risk; AMA; negligence; liability; duty; protections; against medical advice; malpractice; capacity
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/j.jemermed.2011.05.030

Abstract Background Every year, patients leave the Emergency Department against medical advice (AMA) and before an adequate evaluation can be performed. It is well known that many of these patients are at risk of subsequent complications. Objective The goal of this article is to explain the potential legal protections that may be created from a proper AMA discharge. Discussion In this article, the authors review the steps that need to be taken when performing an AMA discharge, including an assessment of capacity, proper documentation, and adequate disclosure. The authors then review the potential legal protections that can result from a properly documented and performed discharge. Among these protections are: proof that the provider's duty to the patient ended with discharge and that the patient assumed the risk of a subsequent complication. Conclusion The authors conclude that a properly executed discharge can provide significant legal protection from liability risks.